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{ 4 <br /> 1 <br /> NON-HAZARDOUS 1 Generator's US EPA ID No DowmentsNo 2 Page 1 <br /> WASTE MANIFEST ar of <br /> Generator's Nome and Mailing Address <br /> Slaby Seles Inc. <br /> P.O. Boaz 903; Borrego Springs Ca 92004 <br /> 4 Generator's Phone( 760 ) <br /> 767-0776 <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporter's Phone <br /> S301— Solesr <br /> 7 Transporter 2 Company Nome 8 US EPA ID Number B Transporter's Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone <br /> WESTERN ENVIRONMENTAL Inc. <br /> 62-150 GENE WILMAS DRIVE <br /> MECCA CA 92245 A P n a n i K 7 ? 396-0722 <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No Type Quanta Wt vol <br /> t <br /> a <br /> N <br /> t1 t• q <br /> G b <br /> E <br /> N <br /> E <br /> R <br /> A c <br /> T <br /> O <br /> R <br /> d <br /> D Additional Descriptions for Materials Listed Above E Handling Codes for Wastes Listed Above <br /> 15 Special Handling Instructions and Additional Information <br /> Wear appropriate clothing, steel toed boots, gloves. <br /> Emergency 24 hour phone (888)701-6600 <br /> Site a, (,AGE) <br /> 1637 Turnpike Rd. <br /> Stockton Ca 95209 <br /> 16 GENERATOR'S CERTIFICATION I certify the materials described above on this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste <br /> Printed/Typed Name Signature Month Day Year <br /> 'laida Harlow for AGE _ `4 <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> A Printed/Typed Name;` Signature Monfht Day Yeoi <br /> S n <br /> P <br /> O 18 Transporter 2 Acknowledgement of Receipt of Materials <br /> R <br /> T Printed/Typed Name Signature Month Day Year <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> r <br /> Y { <br /> Printed/Typed Name Signature Month Day Year <br /> I COPY <br />